Student Employment Services (SES) Authorization Request
Before starting work, students MUST be authorized by the Office of Student Financial Aid. Notice of authorization for student to work will be provided to the Supervisor after this request is processed.
Student Name
*
First Name
Last Name
Student ID Number
*
900 #
Email
*
example@.adams.edu
Phone Number
-
Area Code
Phone Number
Supervisor Name
*
First Name
Last Name
Supervisor Email
*
**Needs to be exact as this is the email it will be sent to (example@adams.edu)
Student Statement:
I have read and understand the policies and conditions described on the SES webpage under which I have been offered this employment opportunity. During the period of student employment, I agree to enroll and attend class at least half time each semester. I further understand that should I drop below half time in any semester during which I am employed, my employment may be terminated. I understand that I can work only the number of hours authorized and agree not to exceed that total. I also understand that I will work and be paid only for those hours approved by my supervisor and that my employment is limited to fund availability.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Supervisor Complete- Office Use Only
Supervisor Password
Name
*
First Name
Last Name
Email
*
example@adams.edu
Phone Number
*
-
Area Code
Phone Number
Student Job Title
*
Department
*
Requested Hours/ Week
*
Pay Rate
*
Employment Start Date
*
-
Month
-
Day
Year
Date
Employment End Date
*
-
Month
-
Day
Year
Date
Work Type
*
Work-study
Campus Employment
Complete for Campus Employment Only: Budget Code
Complete for Campus Employment ONLY
Cost Center
ex CC0015
OR Grant ID
ex GR00003
Complete for Campus Employment Only: Department Budget or Grant Manager Name
First Name
Last Name
Complete for Campus Employment Only: Signature
Supervisor Statement:
I understand that the above named student cannot begin work prior to approval of this authorization request. My signature below certifies that the student is qualified for the job listed and will be employed in this department. I will supervise the student in accordance with SES Policies and am responsible for monitoring authorized hours of employment. Furthermore, I understand that all student employment is based on position and fund availability and am aware that if a student exceeds his/her total awarded funds, my department is responsible for ensuring that the student is compensated for additional work.
Supervisor Signature
*
Date
*
-
Month
-
Day
Year
Date
Proxy Name (Proxy can sign timesheet in the event that the primary supervisor is unavailable. But supervisor needs to authorize proxy through Web Time Entry before the Proxy has access to approve timesheets.)
First Name
Last Name
Proxy Extension #
Submit
Financial Aid- Office Use Only
FA Password
Documents Received
New
Continuing
Documents Received
FAFSA completed
W-4
Photo ID
Copy Social Security
Drug Free Policy
I-9
Title IX Statement
Position Code
Dept. Placement Code
Job Title Code
Copies Sent
Approval
Authorization Approved
Authorization Denied
Total Hours Authorized
Approved By
First Name
Last Name
Submit
Should be Empty: